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Miscellaneous - 23 RICHARDSON AVENUE 4/30/2018
23 RICHARDSON AVENUE 2101031___0-0017'0000.0 ,I a 1, II II 1 II I I I 11 ,1 Iii , r Licensed in MA•NH•W Jack EZXC CU Eiborn & Son Inc. Cowmcwm INDUSTRIIALr •COMMERCIAL•RESIDENTIAL PO Box 676 1 Amesbury,MA 01913 Tel:(978)388-9453 Jack Sanborn, Pres. Fax:(978)388-4902 Mobile:(978)815-6582 Pager:(978)545-2056 Date. .`�r ".O R':'� TOWN OF NORTH ANDOVER 1- p PERMIT FOR PLUMBING A- US� This certifies that . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . plumbing in the buildings of *!�. . . . ... . . . . . . . . . . . . . at - . .—`'. . ' '` ''. ... . . . .r. , North Andover, Mass. Feer. . . . . .Lic. Nw ...y.. . . �PLUB, . . . . . . . . . . . . . . _ U NSPECTOR Check # 8063 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING i<":�.•Rn.un. � ��/ /"'4JGVIZLC. MA A •n. J'{,/ 0n..+ ." vcty��vwn. , mJy. vaac. rcnnnx 8 Buildinq Location: Owners Name: STvJr/C1 � PType of Occupancy: Commercial❑ Educational ❑ Industrial❑ Institutional ❑ Residential [[� New: ❑ Alteration:❑ Renovation: ❑ Reptacement:12/ Plans Submitted: Yes❑ No❑ FIXTURES Z yLu Z a a: z Y a U y Z z rn z 3 V) x W a W y }' W Y N a X M Q w o g Q z n Z Lou Cq z V a �- L.1 V. Q i;n u W (/� ul VH O H = z a L- d Y z X W FW- w a a N N ° a o _ > O = o Q W a a a s W m G G W 0 x Y g g M N W 1- X 3 3 3 0 SUB BSMT. BASEMENT 1" FLOOR 2 N LFLOOR 3mu FLOOR 4 FLOOR CTH Ci 6 FLOOR 7 FLOOR EE _ 8 FLOOR ,,�� Check One Only Certificate-# installing Company Name: ��IZRS t!� �'17�/(0, �C i ilCorporation 9?/,411/C - �I Address: e-0 r '6d 6 CitylTo :�//'I)—U M4Q,"tate- C r- ❑Partnership Business Tel: l 7�VY7✓� Fax: (-�)3d'53 7 7Y�( ❑Firm/Company Name of Licensed Plumber: ' jS INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes"o❑ If you have checked Yes,please incjicate the type of coverage by checking the appropriate box below. 'A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my .Knowledge and that all plumbing work and installations performed under the perk issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By ;Mlausmte of License: Title ber Signature of Licensed Plumber CityCi /flown _ r /Town APPROVED OFFICE USE ONLY) ❑Journeyman License Number: • C�' �!II / / . _. Date......!. .....`.. ...... r HOR7M °t<«`°;•'"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SSACHUSEt This certifies that G ``..... c,:'.. «.t.<.............-'..G:�1 ........................ ...... /} ................ has permission to perform ...... .!. ....................................... wiring in the building of v f � { r l� r i ............... t.,. ............................................ at..... .%.....f� c 1.�,„011 .�r u..!.....9.0`--f—• �f. ,North Andover,Mass. Fee..�. �..<. ... Lic.No.............. , ,-� ......... l� .Lf'.. v Z ELECTRICAL INSPECTOR Check It WHITE: Applicant CANARY: Building Dept. PINK:Treasurer l.ornrnonwsat o�/�assaclut!al� Official Use Octly h"a"s PC:mit BOARD OF FIRE PREVENTION REGULATIONS ev.11199] and Fee CIIe^_?ced Rei. 11l99j APPLICA T ION FOR PERMIT TO PERFORM ,ELE r*) AL WORK All work to be perfarn:Cd in:Ctordanr.with the�tits�:.chuscas E11=6=1 Code r (PLL ISL• PRIINT ILY INK OR T'YPE.IILL NF 1.L•1TION) Date: ��t[ •$'-;Cart 12.0() City or Town of. Q !3y this application the undersigned v To dte Ltspet:Ior of 1Ytres: I cs natter:of IIIc or cr intention to perform the c1ccrricai work described below. tlo r-1)14 it Location(Streit S Number) a !�l(i (� Owner or Tenant C � Telephone i\'o. 7�7 ,a Oa Owner's Address C-4 19 Is this permit in conjunction Ivith a building crmii? Yes fp� iYc ❑ (Chcrh t\pprapri:ic Box) I, Purpose of Building , a• /►' ] Utility Authorization No. �y Existing Service AIn;Is ! Volts Overhead ❑ d No.orUnd�r Ya ❑ 1lete,. itieiv Service Maps 1 Volts Overhead❑ Undgrd ❑ No, oCZIeters' Number of Feeders and Alnpacity Location and Mature of Proposed EIectrial Work: Y . , `—' Comnletion oldie rodult-int,table may be uaired br dre 111-Mer-or of-11-7r=. No.of Recessed Fixtures Itio.of Cc.L-Susp.(Paddle)Fans ItN0.of Tatai I Tr-nsfarmers K'VA `!o.of Liglttiag Outlets Itio.of Iiot Tubs (Generators K'%'.A No.of Lightinga Fixture ( Above ` !n-Swiming ❑ I � e. C1 1I=SICIII7PIorad. o�d• (B:ttery Units i No.of Receptacle Outlets (Yo.of 01 Burners FIRE AL,1RXS.Ii1o.of Zane: Into.Of S/SltChes I'No.of Gas Burners II`io.of lletecuon and j y \u.of Ranges Ilia.of Air Cand. Totalata! Initiating Devices Tans INo-of Ale.-lino Devices I >o.of Waste DisposersHat Yump tiuntbcr •tons I Ii1V rl'a,of Scf{ontained Totals:I I 1Dete-tionlAlerting Devices 1 No.oCDislntijshers c . I..p..r�:1reZ Heating I�'1V Local ryiunicip:i ❑ Connection ❑ Other I No.of Dryers IHe:tinr AppliancesI�1�% ISecaritySvstcros: I`!o.ot•\later NO of Devices or Eauiti-.Ient Heaters XV; !r\o.of IV o.of Salo Ballasts _ I nW-1rin7: , j�-..!..!'o.ofDe�•icrsarEouivaIent No.Hydromassage BathtubsNo.of Motors Total IIP I Tcie-ommunicatioas Wiring: OTHER: No.of Devices or Eauivatent I ,4aach add&ianal detail if de:ir�;or=��by Ilie lusFtc.,or aj fres. IJ SUR.��tCE COVERAGE: Uniess«'jived by the writer,no pe. t far the pGforsntltce of electrical wort;may issue unless the Iicense--provides proof of liability insurx=including:"completed operation'coverage or its substantial equivalent. file undersigned certifies that such covers_e is in force,and has e~ixibited proof of sjrne to the petilsit issuing office. CHECK ONE: L\rSUR:\NCE 91, BOND ❑ OTI•iL-R ❑ (Spr-ify.) Estimated Value of EIectr,•caI Wotl.- (When re:Itlirri byrnullicip:i policy.) (E--p'r.�ian D:re) Work-to Start: •- © Inspections to be requested in accordane=Aid,1.lEC Rule 10,and upon comple:ian. t ccrtt�; frit /tr JJ r �ZL[IS.Qrrr/narrnrtire.n�errin�•.fltllf Ille 11IfUrlrralIOt!alt Ili!$Q!f!)l1CQI2alt lS..IT:tY Qrt(t•COIlrF1C'IC'. FI ILA I N Jade. _ _ _ _ LIC_NO.: Licensee: Fi SOil IrbC:. mmuao� �Ign:ture rlfQ,,Pri�i= -' 6.:• . .. vLid LIC.iro 3 Q:�aac _luneibtvy,MA-01913 Btu.Tei i`to. address: .. _... .. n8- VIS'- ASF ?AX Tel.Itio• — 1a� O%Vt lER'S Ii`ISUI2.a;`(CE WAIVER: I am aware that the lic!U! doer net!rave the li:bilily itlsutance cocers_Ee normally required by las. By my si:_Itaturc below,I hCreby waive this requir:rnc:It. I am the(chccl;one)❑owner �, OwnedAgent ❑o�rncr's a_raL Signature Telephone No. PER11rT F'EE:S .. I S a -r * hill, ;, ns, ll'i se Licensed in MA•NH•ME os-o ps-osis. Z Jack eel —ask-,E�trer, -3.x ^-Now- gsgi web ELEC77=AL Rte,, born & Son Inc. CONTRACTORS 1:SANBQRN JACK INDUSTRIAL• COMMERCIAL•RESIDENTIAL 4 BIRCH LN, gMt:BBURY;�MA - PO Box 676 -0181 Amesbury,MA 01913 Tel:(978)388-9453 Jack Sanborn, Pres. Fax:(978)388-4902 ~ ' iMobile:(978)815-6582 Pager:(978)545-2056 U. 'v t' -"" ---- -----� ------- - COMMONWEALTH OF MASSACHUSETTS ,-, l STATE')MOF NEW 11AXPSHW OF ELECTRICIANS EIAhTSB©ARD . - AS A REG JOURNEYMAN ELECTRICI CrE1•�5 1IiA ISSUES THIS LICENSE TO '�. JACK V SANBORN NAMETACK v :r y G1 • :: I5 LiCENSEfJ AS A MAS`I'BR ELECTRICIANP)1R RSA 339 C PO BOX 676, �•,� � ` x;.Es.• (1��3I � , .•�,,;� AMESBURY MA 01913-0015 _,.� : 16203 E 07/31/04 327448 BIiLS C Kky3KTJ3T BE PRESENTED-TG THE ELECTR,aMS BOARD • • • ® - INSPE6TOR UPOPr REQiFEST. r Fold,Then Detach Along All Perforations �sa0191 ?: STATE OF MAINE Chusetts INS +rTIAN TOFPROFES510NAI&PINANCL4LREGJLaTIt�N y ELEC'T'RICIANS EXAMIN WG_BOARD DEPARTMENT NAME '.. • LICENSE#MC66017500 JACK SANBORN %� r 50645 � lDiro/(�6� �`� , ' JACK SANBORN &SON INC aTU LICENSED ELECTRICAL COMPANY' affiliated with JA('K V SANBORN • F V IDATIN OF I �7G1G7/G//4 a 4 i ISSUED NOV 16, 1999 F-vfIRES D$C 31,2001l ' Location No. Date MORTM TOWN OF NORTH ANDOVER � 9 s ; ; Certificate of Occupancy $ Building/Frame Permit Fee $ -` S�GMUS • - Foundation Permit Fee $ Other Permit Fee $ ` TOTAL Check # 15 ,J 4 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: I DATE ISSUED: SIGNATURE: Building Commissioner/I for Buildin s Date SECTION 1-SITE INFORMATION 1.1 Property Adddrress: (� 1.2 Assessors Map and Parcel Number: 3, 1` t �_`k AA d -e Map Number Parcel Number G 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Re red Provided Required Provided 1.7 Water Supply M.G.I-C.40.5 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Naive(Priory' Address for Service: Signature Telephone O 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ e N• Licensed Construction Supervisor: Q I ? 5— t fLicense Number Address ! t ,�,� p ,t�� Z p� u " � U Q � Expiration ate Signature Telephone 979 ' 975-12 ? 3.2 gistered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address 7110z- Expiration Date Signature Telephone I � F` SECTION 4-WORKERS COMPENSATION(M G.L. C 152 § 25c(6) I ' Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work check all a hcable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Speci i, Brief Description of Proposed Work: k (/2- SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to bef� FFIC3AL'USEzON� � S�a Completed by pentut applicant ` ,i� <. di. r .pf � . :, ` 1. Building (a) Building Permit Fee � Multiplier 2 Electrical (b) Estimated Total Cost of I Construction 3 Plumbing Building Permit fee(a)x (n) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERSAGENTOR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ���✓��` N as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building pennit application. r Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature re of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I s 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS D�NSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BU11DING CONNECTED TO NATURAL GAS LINE NORTH own of over No. ` r7 ?, _ " .. ei �4A CO- y over, Mass., ORATED S H E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ... ................................ ....J4.�..... ...................... Foundation • has permission to erect........................................ b ildin orl� ...... ..... ....6 Rough to be occupied as ... VW . ........................................... Chimney .. . . .. . . . . .. . .. .. . . . . . provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Fina' UNLESS CONSTRUCTIONS ELECTRICAL INSPECTOR Rough .......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. a r ' North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL j c11, S150A. The debris will be disposed of in: � (Du vvt L�- IsP w v \ Location of Facility) Signature of e e Applicant 00// ,3/0/ Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector ^�- -- � �✓fie �aar�naansr.ea,�� o�,/�ja��cYc/zrcdeCfiJ I BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 012698 Birthdate: 07/27/1950 s Expires: 07/27/2001 Tr.no: 11429 Restricted To: 00 BERTIN R ROY 195 HAVERHILL STe METHUEN, MA 01844' _ Administrator € HOME IMPROVEMENT CONTRACTOR t' Registration: 105393 Expiration: 7/17/02 Type OBA n BERTIN R. ROY CUSTOM BUILD Bertin Roy zl4 G� o 4�r-zal 195 HAVERHILL STREE ' ADMINISTRATOR METHUEN MA 01844 t a a The Commonwealth of Massachusetts d Department of Industrial Accidents w Office of investigations J Ra w Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name Location `Z, City 6!/l e—'ONJ Phone # 7 m a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address City: Phone#: Insurence.Co.. Policv# Company:name- Address r City, Phone-* Instlrans .Co. . Policy..#. • Fai1 rj secure coverage as required under Section 25A or MGL 152 can lead to the bipos�on of criminal penalties of,�fine up to$1, Op and/or one years'imprisonments well-as-civil.,penalties.-in-th&l mnf-aBrtoP:WDRK-OiR ERAad-:a-fine of�$1IlO Iq.atlay-againstme. I understand that a copy of this statement maybe forwardedto the Office of Investigations of the DIA for Coverage vetrfication. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date Print name Phone.# official use only do not write in this area to be completed by city or town official' r - City or Town Permit/Licensing C7 Building Dept • ❑Check if immediate response is required .0 Licensing Board F1 Selectman's ice Contact person: Phone#: Health Department Other �i Date Z.......�......:. No ....... NORTN 3r°;<�``°.;•�"a°� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING • '4 AT�° ,SgACMUSE� This certifies that has permission to perform .....:................I.................:................................... wiring in the building of.............1-;......... ..... ..... .............................. at..,. .....!...........................::..............1.:........%......... ,North Andover,Mass. Feels....:.:...... Lic.NoIV! ...::: ............................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer y. TLE COAMOM�, LTHOFA4MMUSMS Office Use only DLPARTjVEYTOFPL MC.SA= Permit No. /5;;4—? BOARDOFFIREPREV=ONREGUTAHOAS527CUR12-00 !�O Occupancy&Fees Checked A pLICAT70NF012PERM7'TOFFRFO"ELE'C7RICAL WORK ALL,WORK TO DE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 c"a 12:00 (�` / — IC ` (PLEASE PRINT IN INK OR TYPE ALL INFORMAT ION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. V4Ap J, PARCEL UU Location(Street&Number) 6er Tenant ^ Owner's Address Is this permit in conjunction witha building permit: Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service O�D AmpsI�L %lts Overhead Underground F7 No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of d an Ampacity Location f Proposed Electrical ork ,1 No.of e kefol No.of Transfonnets Towl KVA FAbove. Below GeneratorsKVA and andNo.of R ceptac a Outlets ) No.of Emergency Lighting Battery units ch is No.ofNo.of Air Cond. Total FIRE ALARMS No.of Zones Tons isP a No.of Heat Total Total No.of Detection and Pumvs Tons KW Initiating Devices N is n Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dry Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Si Bailasis No.Hydro Massage Tubi No.of Motors Total HP OTTER- / c �c hstuanceCd�aar Aas�trtmttiet¢ernapsoflVlass3da�lSGerie<allaws F7 Iha�3wnattliabibtyh�staamel�icyimbr]BIgC a aa�o oritsstbMn6 e#valaA Iha«st>�rr> vabdpto�of YES I' a If}w1�zd �YFS pl�ethetypeof�aab5 d��g INSURANCE ID 0111ER Fgase Spey) �✓!c14E'Faarari1)m ValuedEkcbcal Weds$ WaktoStart I tII�reR�t>e�d Fsal /p Sigrioduo las 2 Li eNa ll Q I,,F:NINAME L.mnee Signanae L�eNo ��� �" Alt TeLNa alas tyfvL�sacyn�lsCc�alLaws OWNER'SINS(�RANCEWAIVER;IamawaieffrltdrLicertsedoes MAInwedr anaas�critss�i antialec�m te�ta� and dyrtmysicr.�uemtbisp=rrr¢aPPlintialwai<•Es tlris=4Men= b (Please check one) Owner D Agent Telephone No. _ PERMIT FEE $ Siar_anze of owner or agent t CAmrtgnvoeaFt�i o[IllassRc�iusstis 3 DVERxS LtCEI �, 6905 DM ''+ Bi SANBORN 20CGLENWOOD ST y< AMESBURY MA 1913-1128 i a.A COMMONWEALTH OF MASSACHUSETTS STATE OF 14A M x OF PROFESSIONAL&FNANCL4,L REGULATION,. I ELI0 F ELECTRICIAN S ; CIANSEXAN flNINGBOARD ; i REGISTERED MASTER ELECTRICIAN LICENSE#MS60004528 j Ij ISSUES THIS LICENSE TO i i' JACK JACK SANBORN & ,SON INC t` �''SANBORN j JACK V SANBORN ,. m LICENSED MASTER ELECTRICIAN , t PO BOX 676 ° AMESBURY ISSUED MAY 11,'1998 EXPIRES JUN 30,2000' M A 01913-001.r 11833 A 07i31/01 667585 TEL:(978)388-9453 LICENSED in MA-ME-NH FAX:(978)388-4902 STATE OF NEW HAMPSHIRE PAGER:545-2056 ELkCTRICIANS BOARD JACK SANBORN & SON INC. CERTIFIES THAT INDUSTRIAL •COMMERCIAL•RESIDENTIAL NAME JACK SANBORN r u ! - 4 20 GLENWOOD ST. IS LICENSED AS�A MASTER ELECTRICIAN PER RSA 319-C PO BOX 676 t r LIC 570x4 M EXPRE$ 05/31/00 .k JACK SANBORN, PRES. AMESBURY,MA.01913 1 r THIS CARD MU QBE PRESENTEDTO THE'ELECTRICIANS BOARD` INSPECTOR UPON EQUEST.. Date. .n/. s TOWN OF NORTH ANDOVER , o ° PERMIT FOR PLUMBING • i, r r;�ss�cwus��y r ~ This certifies that . . `. . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . has permission to perform . . :. . .g . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . orth Andover, Mass. Fee,;�"r Lic. No../�! .t. . . . . . �. . . / PLUMB IN�G^OECTOFI Check # � `� 4 > 66 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING i (Type or print) NORTH ANDOVER,MASSACHUSETTS 1Date 0 17—26 Building Location 2 3 P tc6 and-Sor) A-Ue.Owners Name U5""[7x5iol7eee-10kerPermit#_ z Amount _ dD Type of Occupancy New Renovation Replacement El Plans Submitted Yes No FIXTURES Z d S[&HgVIC RAA411'II�Q' lS�FIOCl2 ZTI]FIOQ2 3HIl FLO�t 4IH RaR 5M FIOM 6M H-OCR 7M FLOCIR SIH FIOCR (Print or type) / n�"" Check one: Certificate Installing Company Name /,t�k1le A 6416- Pf / GO/ Corp. /&d 9 C Address Box728 Partner. Alarfh Pi-n do v er . n-f o- 0 49 4- Business Business Telephone 0179 ' 97S 42-92 Finn/Co. Name of.Licensed Plumber. CZvbe rt t3 IQ nc /f i° ll-Q- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: r Liability insurance policy ' \ Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above o three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued r this application will be in compliance with all pertinent provisions of the M chu Stat Plumbing Code 9nd Chapter 2 of neral Laws. BySignature of Licenseaer ` Type of Plumbing License Title 6 S Q 7 City/Town License i um er Master Journeyman APPROVED(OFFICE USE ONLY Location Y- ` Nf' -+�- �✓ No. Date .... . TOWN OF NORTH ANDOVER 3? OL illift p Certificate of Occupancy $ Building/Frame Permit Fee $ ,SSACNUSFoundation Permit Fee $ f . Other Permit Fee $ Sewer Connection Fee $ C.-Watee'Donnection Fee $ OCT rr TOTAL ! J Y 1 Building Inspector + ,' .t,�.L . Div. Public Works PERMIT NO. Y3� APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAPvO. LOT NO. 12 RECORD OF OWNERSHIP '.DATE BOOK '.PAGE ZONE , SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING OWNER'S`Idi4 ME —rer r J �,j/(}'0 a IJ AO k P r NO. OF STORIES SIZE OWNE�'' ADDRESS I) 7 /7 f_ `v�I��� � BASEMENT OR SLAB - ARC ECT'S NAME �C /C SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME (� i Cf SPAN -- DISTANCE TO NEAREST BUILD'IN'G DIMENSIONS OF SILLS DISTANCE FROM STREET •• POSTS DISTANCE FROM LOT LINES—SIDES REAR •• GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION �l '� ` IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE yell - IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 F1II- ))\\LL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM 1111 SEPTIC PERMIT NO. ELECTr7CC,SAETEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED (/ 7 j2 aZ BOARD OF HEALTH SIGNATURES OF OWNER OR AUTHORIZED AGEN F E E / PLANNING BOARD PERMIT TE,y BOARD OF SELECTMEN BUILD S OR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I roRIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDWD PIERS PLASTER _ _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'TAREA V, 1/1 1/ FIN. ATTIC AREA _ NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING. HARDW D _ ASBESTOS SIDING COMMON — VERT. SIDING ASPH. TILE _ STUCCO ON MASON14' STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR 1--1POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) — GAMBREL MANSARD TOILET RM. )2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 7. NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING NORTH Town of Andover No. 43S 000' K er, Mass 197 C MEWICK 019 ?P SS BOARD OF HEALTH PERM' IT T LD THIS CERTIFIES THA ... .. .. .�P. .. .. ....................... BUILDING INSPECTOR has permission tq- A5&-' ........... ....... buildings on .... Rough to be occupied a � FialChimney , '�'�'�' � Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids is Permit. PERMIT EXPIRE IN 6 NTHS ELECTRICAL INSPECTOR Rough UNLESS CON TRUCTI SAT Service Final .. . . . . . .. ... ... .. BUILDIN .•PECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buil g Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be Done , Until Inspected and Approved by Smoke Det. Building Inspector t ^ Town Of North Andover Project: Building Department 01 HORTN 27 Charles Street 0 ' ' °p Th ,2 978-688-9545 APPLICANT : SS^cHugEtth a3 /2ic RE: c;2 �rCi'jARG�sd � y{ DATE: Title of Plans and Documents: Please be advised that after review of your Building Permit Application and Plans that your Application is DENIED for the following reasons: Zoning Use not allowed in District Not in conformance with Phased Development Violation of Height Limitations Sign exceeds requirements Violation of Setback Front SidefK Rear Insufficient Lot Area Insufficient Parking Violation of Building Coverage Insufficient Open Space Use requires permits prior to Building Permit Sign requires permits prior to Building Permit Form U not complete by other departments Not in conformance with Growth By-Law I I Other Remedy for the above is checked below. Dimensional Variance Special Permit for Watershed Review Special Permit for Site Plan Review Special Permit for sign Complete Form U sign-offs C onv of Recorded Variance Information indicating Non-conforming status Copy of Recorded Special Permit Other Other S ec �,f if/p�/ CoN rrl7 ti9 ,Low Plan Review The plans and documentation submitted have the following inadequacies : 1.Information Is not provided,2.Requires additional information, 3. Information requires more clarification,4. Information is incorrect. 5.All of the above. # I # Foundation Plan Plumbing Plans Subsurface investigation Certified Plot Plan with proposed structure Construction Plans 116 Affidavit Mechanical Plans and or details Plans Stamped by proper discipline Electrical Plans and or details Framing Plan Fire Sprinkler and Alarm Plan Roofing Footing Plan Plans to scale Utilities Site Plan Plot! RO Water Su pl Sewage Disposal Waste Disposal Other ADA and or ABBA requirements Administration The documentation submitted has the following inadequacies 1. Information Is not provided.2.Requires additional information. 3. Information requires more clarification.4. Information is incorrect.5.All of the above. # # Water Fee State Builders License Sewer Fee Workman's Compensation Building Permit Fee Homeowners Improvement Registration Buildinq Permit Application Homeowners Exemption Form Other Other The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to . provide definitive answers to the above reasons for DENIAL. Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative"shall be attached hereto and incorporated herein by reference. The building department will retain all plans and documentation for the above file.You must file a new building permit application form and begin the permitting process. Building Department Official Signature Application Received Application Denied If Faxed Denial Sent Referral recommended : Fire Health Police —zoninq Board Conservation Department of Public Works Planning Historical Commission Other BUILDING DEPT cc: William Scott Revised 9\97Im Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the building permit for the property indicated on the reverse side: Code Reasons for Denial Reference JWP ka/ Ste/ 7`li Jc // op . e/, O' O zj z y .A f 6/4 IWO� T 7 nowhl A •��'. �.w+� NO Allb M s z.x L . / Town Of North Andover , of"°�';�� Project: 23 RICHARDSON AVE Building Department 3? �" O p 146 Main St. Town Hall Annex °,' • `'� . ••045 y,SSACHlI5E4 978-688-9545 APPLICANT: TERRY STONECIPHER DATE: April 20, 1999 RE: BUILDING PERMIT APPLICATION FOR 23 RICHARDSON AVE Title of Plans and Documents: Please be advised that after review of your Building Permit Application and Plans that your Application is DENIED for the following reasons: Zoning Use not allowed in District Not in conformance with Phased Development Violation of Height Limitations Sign exceeds requirements X Violation of Setback Front Side X Rear X Insufficient Lot Area Insufficient Parking Violation of Building Coverage Insufficient Open Space Use re uires permits prior to Building Permit Sign requires permits prior to Building Permit I Form U not complete by other departments Not in conformance with Growth By-Law Other Remedy for the above is checked below. X Dimensional Variance Special Permit for Watershed Review Special Permit for Site Plan Review Special Permit for sign Complete Form U sign-offs Copy of Recorded Variance Information indicating Non-conforming status Copy of Recorded Special Permit Other X Other Special Permit non-conforming lot and side setbacks Plan Review The plans and documentation submitted have the following inadequacies : 1. Information is not provided,2.Requires additional information, 3. Information requires more clarification,4. Information is incorrect. 5.All of the above Foundation Plan Plumbing Plans Subsurface investigation Certified Plot Plan with proposed structure Construction Plans 127 Affidavit Mechanical Plans and or details Plans Stamped by proper discipline Electrical Plans and or details Framing Plan Fire Sprinkle and Alarm Plan Roofing Footing Plan Plans to scale Utilities 2 Site Plan CERTIFIED PLOT PLAN Water Supply Sewage Disposal Waste Dis osal Other ADA and or ABBA requirements Administration The documentation submitted has the following inadequacies : 1.Information Is not provided.2.Requires additional information. 3.Information requires more clarification.4. Information is incorrect.5.All of the above . Water Fee State Builders License Sewer Fee Workman's Compensation Buildin.q Permit Fee Homeowners Improvement Registration Building Permit Application Homeowners Exemption Form Other Other The above review and attached explanation of such is based on the plans and information submitted. No definitive review and or advice shall be based on verbal explanations by the applicant nor shall such verbal explanations by the applicant serve to provide definitive answers to the above reasons for DENIAL. Any inaccuracies,misleading information,or other subsequent changes to the information submitted by the applicant shall be grounds for this review to be voided at the discretion of the Building Department.The attached document titled"Plan Review Narrative"shall be attached hereto and incorporated herein by reference. The building department will retain all plans and d2pumentation for the above file.You must file a new building permit application form and begin the permittin roc WN PY44^44- { 4/12/99 4/16/99 Building Department Official Signature Application Received Application Denied 4/20/99 If Faxed Denial Sent Referral recommended : Fire Health t Police X Zoning Board Conservation Department of Public Works Planning Historical Commission Other cc: William Scott Plan Review Narrative The following narrative is provided to further explain the reasons for denial for the building permit for the property indicated on the reverse side: Code �teasons for:Denial Reference Section 9 Non-conforming uses 9.1 preexisting non-conforming used and structures Unless there is a finding by the Board. Table 2 summary of dimensional require- ments. R-4 area required 12,500 s.f. provided 9,249 s.f. insufficient area 3,251 s.f. Required setbacks in R-4 front-30 feet, side -15 feet, rear - 30 feet. a i a I 1)Ii-'R M IT NO. APPLICATION FOR PERM IT TO I3UILU********NOR'h11 ANDOVER, NIA nl u'No . I LOI.No . 2. RL('ORDOFON'NLI(SIIII' 1):+TE BOOK PAGE 1(1hE (SITU hl\'. I.OT NO. 1()( ►IRON ,�} �(f� .LL_ !� PURPOSE Of BUll DIN(: ()\%,NER*SNAI.IE % NO. 01:STIMES SIZE C �-ec ( /� ()WNER'S ADDRESS S BASEMENT OR SLAU _ AM'I III ECT'S NAME SIZE OF II OOR IIMBERS ISO 2 ND 3 RD IM11 DER'S NAME `� i7 ® SPAN - DISIANCE10NEARESI BUILDING ` l� DIMFNSI(NJSOf:SILLS DOS I ANCE I HO M S I REE r DIMENSIONS 01 1'(7615 DIS IANCE FROM LOT LINES-SIDES , REAR 3�fi/7 DIMENSIONS OF GIRDERS � FROM J� 5D1� IIEIGIIT(N FOUNDATION AREA OF LOT � IS BII1LDItJ(i NEW SIZE Of-,I O(JIING 6 X IS BUILDING ADDI IION MAI FRIM.OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OITTII 1 ED LAND "91 1.BUILDING COk KAIM TO REQ IIREMENI S OF CODE IS BUILDING CONNECTED'TO'TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECI III)TO TOWN SEWER a IS BLAMING CONNECI ED TO NATURAL GAS LINE INSHWTIONS 3. PROPERTY INFO RA IA I ION LAND COST Es I. BLDG. COS r Q 000 , c)-o vva-' I FII.I.O(IT SECTIONS 1-3 EST, BLDG. COST PLR SIS.FT. ESI. BI DCi.COS I PER ROOtA EI ECTRIC LIEI ERS 1,11.ISF BE(AJ otI rsiDE(N BUILDING SEPIIC PERIM I NO. AI'IACI IED GARA(iESmus TCONFORM ToSTATEFIRE RE(RILAIIONS 4. AI'1'IU)vvi)Bl': PLANS MUST BE FILED AND AT'PROVED BY BUILDING INSPECTOR BlII1.UING INSPk CFOR DA It:1111:1) �/7 �/ OWNEILSTEI.X. g s— 74// (E n F 4 4_ CON'IR.'II:I CON IIt.1.ICX e-') W 9 O ! ITT tiIGNA I I IRI:Of( "'NIAt OR All 1110RIZ1i )AGI N f f � �7 q Irl ILLC.11 �OS S / 3 L I'1 Itf`II 1 GIt.AN 11 I) 19 r� ,f i �1 '01C i i � I i I i I � i I 1 � . � ,� I i _ __ --- _-----_ '_, i 1 � �, � :�7` i � i , i - I , - ��'' U -- - ----- _ _- ---� _- -r-�-- - � ���� I `� � � i i =..- - __ � - - _.� � - � � I I �� i i 1 _i I - ----- i � � - � _ �8��" ��' ��� � _�._ , z • _ ` __ The Commonwealth of Massachusetts -= -- - Department of Industrial Accidents — Office of/nyestlywans - 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit narric location: city nhone I am a homeowner performing all work myself. F1 I am a sole proprietor and have no one working in any capacity r7 I am an employer providing workers' compensation for my employees working on this job. company nazte address:... city' nhone# insurance co: Policy 4 - r7 I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comnlay name: address: city phone 4• iasttt;isacs co, policy# C address: :.2�:. /V 2.�./ �� city_ C( )/P phone#• Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one yean' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. l understand that a copy of this statement may be forwarded to the Office of lnvestigations of the DIA for coverage verification. 1 do hereby cenijy under the pains and penalties of perjury r he information provided above is true and correct 9 Signature Date �Z Print name Phone 4 official use only do not write in this area to be completed by city or town uncial city or town: permit/license# fl Building Department �Liccnsing Board Q check if immediate response is required []Selectmen's Office L7Health Department contact person: phone q; Fl Other (r—wd 3195 PIA) - ���o J �.cao�� ct.n/2 N��'� ���� �� {�� I `�S _ ',�� � � � • � �� �A,^ " 1 l s i l _ � .,.— - :.•.t��" ✓�e (/'n i�aurcyrral•c��/� r,., l�rl.tc[��rrJc/l; 1 y DEPARTMENT OF PUBLIC SAFETY i CONSTRUCTION SUPERVISOR LICENSE Nunber: Expires: Birthdate: CS 012698 0712711999 0112711950 Restricted To: 00 BERTIN R BOY �•�•+..�1rt.✓ 123 NORTH ST ANDOVER, MA 01810 i 61 C2 V all \\ F C,\A FINI, Ar O,Ac) C.�, 00 \ v ko 9 n y(�, > o5,�� \ `D 2 $ 3 \ l C C) \S b 2� 6 Sti. O �3 \ 6 �F. � p 5F. ('� \o.\5 0 Nw000 �00k+ - 2�j y F OOP � O gE O G X00 7 Date./O l`?�: c . MS i HOR71y �r�.<���°„•��ao� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 'SSACMUSE� --� This certifies that . . .C . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . * plumbing in the buildings of • . . . . . . . at ' h Andover, Mass. Fee�-�.l. .Lic. . -. . . PLUMBI I PECTOR 10/15/99 13:49 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING U9 (, Type or print) /dcq NORTH ANDOVER,MASSACHUSETTSDate uilding Locations 2 3 f2 c c h 0 r 4 G0 A A V en U e Permit # Amount -s�5 Mt7, Owner's Name Te rrcy stone c i ph sr New❑ Renovation (a Replacement ❑ Plans Submitted n �l FIXTURES CA w d� w zCA CA F- a w a w a PG F Q w a Pr d F" w x w d d a A A In d F a � d POG � C SiSBgVIC R4SE M ISI±MOOR 2M RaR IM IZOCR 4IH FL" 51H FU= 6M Ili= 7IH FU= SIH FUM (Print or type) __// Check one: Certificate Installing Company Name w h!fC IeV CIC eOrP, rM Corp. /('00 4 C Address 136X ?X 8 ❑ Partner. NO rth A nd o V e 18 4 6 Business Telephone q-7 _ 9 7 5 —-'2 q q ❑ Firm/Co. Name of Licensed Plumber: QOb`'r+ a, Q 1 C1h G h Cf t Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: ❑ Liability insurance policy Other type of indemnity ❑ Bond Insurance Waiver: I,the undersigned,have been mdde aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Ma sa usetts Stat�umbing de and C f the General Laws. By: Signature o Icens um er Type of Plumbing License Title g g q 7 City/Town License Numoer Master Journeyman ❑ APPROVED(OFFICE USE ONLY Location r-23 �JC A a odSy u Au--e- No. y--e-No. 3 4. r Date 8113h NaRTM TOWN OF NORTH ANDOVER p Certificate of Occupancy $ + � • ; Building/Frame Permit Fee $ f� � ���'' Foundation Permit Fee $ sACMUS Other Permit Fee $ Sewer Connection Fee $ 4 Water Connection Fee $ TOTAL $ —� Building Inspector i J /1069 11.22 65.00 RAID Div. Public Works Location oZ 3 Rk C- �A J) Y1`x- `l`�� Date �3�o 3 No. MORTp TOWN OF NORTH ANDOVER 3r •' •SOL F A �• ,�; Certificate of Occupancy $ �'�J'•^•'''<� Building/Frame Permit Fee $ su,wsa Foundation Permit Fee $ Other Permit Fee QAp` $ 5 D TOTAL $ `� U Check # A) / 7 '� 64 - j' Building Inspector I'CI;1ZMIT NO. 3 (n. / APPLICATION FOR PERMIT TO BUILD***** *NORTH ANDOVER, NTA AI,�I'NO- 31 LOT NO. I 2. RLCORDOFoN'NFRsIIIP n.- TE BOOK PAGE IONS SStIIt DIY. Po IION LO"1 NO. .,I r r ()C.�'ft\i�/ A-Fpc�0� l�l��•P� I'lllil'OSt:OFnIIII.DIV(: 'erne -L° JQ- (5 Ut) WCL( O\1MAI'SNAi\I F. ��` ^ LO e GI A��n NO.OF STORIES �q��/� A4� l�� 40 ep / SIZE O\\'N tilt'S:\I)DIiF.SS a3 d` l�_n SOJ 'l. uASEn1EN-roRSL.�n rt I AltCHITEC'l'SNAME 1\ R SIZE OFFl.0Olt,rlAIIIElks ISI 2NI) 3RD I11111.DLIl'SN:1KIL Bek$ Zoe SPAN DIS"fANCE"1'O NEARESI'lillll.DINC DIMENSIONS OF SILLS DI.S'fANCE FROM STREET DINIENSIONS OF POSTS i)ISTANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS ARTA OF LOT FRONTAGE IIEIGIITOF FOUNDATION T1HCICNESS IS BUILDING NEW SIZE OF FOOTING X IS III)ILD ING ADDH ION MATERIAL OF CII@INEY IS Il11ILDING AI:fERATION %� LS BUILDING ON SOLID OR FILLED LAND Wit I.BUILDING CONFORM"f0 REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER nOAIil)OF AI'1'F:AI.S AC'I'ION, IF AN1' ao_C� 1 �n`p as f �� [�� 1S BUILDING CONNECTED TO TOWN SEWER (Q -so Lu c IS BUILDING CONNECTED TO NATURAL GAS LINE INSi'I ICf1ONS 3. PROPERTY INFORMATION LAND COST EST. BLDG. COS"l' (O OOOF P 1G F. I FILL OUTSECTIONS 1-3 EST.BLDG.COST PER SQ. FT. n EST. BLDG. COST PER ROOM I'I f.CFIiIC\It:'fFRS MIIS"I'lIE ON OII"fSIDL:OI'IIUILDING SEPTIC PERMITNO. "I'I'A('lIF-D G:�RACL:S t IUSI'CONFORf l TO SI':1Tt:FIRE Rt:GUL,1l'IONS a. APPROVED It Y: A) PLANS MUST IIF.FILFD AND APPROVED BY BUILDING INSPECTOR It[IILDING INSPECTO11 D.-\IT FILED � O\\'NERSTEL# 067—� l � A CONTR.TF.LII �I �S – o- CON"f1i.1.I0I ©/ >–Z SIC:N l l'IiItE OF O"'NER OR AUTHORIZED AGENT a/3 I'I:RAIIfGR:\WILD 12c)iscll i/S/99 .1N1 - -- - - - - I `y FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departmehts having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT SEC! _ PHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION ki , ,/ - LOT (S) STREET G /9-9 J S dl—') /�`e— ST. NUMBER C3 *****************************************O F F I C IAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: 0Lit— CO SERVATION ADMINISTRATOR DATE APPROVED 'S o tic, DATE REJECTED COMMENTS G.el `b I) TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9W jm 4 iit �C c; r y vGj rr z. ngA�b. �0 lo�40' /ey�aSao 4(,0 Pejo oma, I Toffs �'OP Saa9o�b a ;f p�, _ ,�a✓� 'ids �.�c )/ 'J-190 +: P �o'G 'doeoo, I dd �O SON °/ f a d0 S�H11N1 M �p�3 NI sa33 s3�n�01 S,swl 1 C)NI8 d�31�n03�aN�d11�3a Ned Sl O SNOT 3ndN 11dN1 ��9W��1 3H Od"oI a3W� ��WOq1NOW �/N �iN Ny��Hd S�V#Nd Id -VN I dO v I ,00`o �ti (30 S 3�d SO NMON11Q���, ONa"d31 I 1 33?31S Si dN sI OVASSaINs63r aNd 3H13�d P 1993 uv UPON $ IaAopVj ao 05 pOo�OPaII9 S 1}o S 1 Sa'+o N009 a3SSad 3351 S 8"3 N£6 ddd�6d�a1SI4 o"INO oN a _'o£ 3 � - ,, .(3.8.9.0 L,'130��-�SI1 1 9.n3, o£,.,1 d� �� �� 1 .06 ���:31d S dQNoON � �. Nalo�NO �9 a3d N118 �� .SSdW 1�-3no QNN, Nd QNO �o i NILS ,,:ate o ' 7 h A 3& PLAN OF LAND IN NORTH ANDOVER, MASS. OWNED BY TERRY R. & LINDA S. STONECIPHER SCALE:I"=30' DA TE 4126199 REV:6/23/99 p' 30' 60' 90' j - Scott L.Giles R.P.L.S. NOTE: Frank.S.Giles THE ZONING DISTRICT IS R-4. 50 Deer Meadow Road SEE ASSESSORS MAP 31 PARCEL 17 North Andover,Mass. SEE DEED BOOK 1350 PAGE 93 N.E.R.D. THE PROPERTY LINES SHOWN ARE THE �1N LINES DIVIDING EXISTING OWNERSHIPS,AND �, THE LINES OF STREETS AND WAYS SHOWN N4 ARE THOSE OF PUBLIC OR PRIVATE STREETS OR WAYS ALREADY ESTABLISHED,AND NO NEW LINES FOR DIVISION OF EXISTING .139 OWNERSHIP OR NEW WAYS ARE SHOWN. /STERE I LAND per" (,J-Z-3199 �T T S.B.IFND.J N/F BAKER �2 tia Cb' ti �h• oo. est F NIF CAVALLARO s��P S.B.IFND.J Rte:o QOM. Aar PROP. y. PORCH EXTEN. LOTS 'A'& 'C' PLAN#457 N.E.R.D. 9249 S.F. N/F MONTGOMERY NQ, ¢�9 N/F PHELAN N/F TROMBLY THIS IS TO CERTIFY THAT I HAVE CONFORMED WITH THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS IN PREPARING THIS PLAN NORTH ANDOVER ESSEX N RTN.REGISTRY OF DEEDS BOAR OF APPEALS d r�rtldr�Lf"JC , rAASS:.—��! 4 Thv F COPY: ATT:ST: R—GISTER OF DEED ' 8n � . -_ � yV \ z—'�-au-~~""d"=«natemmA�u:x�� JOyCc / /���U SAC LJS JULTCvvw OF NORTH Amo�]vER - MASs*cHusET7s BCABO {]F /\PpE/\LS Any appeal shall be filed within(20)days after the date offiling cf this notice NOTICE OF DECISION in the office ofthe Town Clerk.. Property at: 23 Richardson Ave. NAME: Terry R. Stonecipher DATE: 7/15/99 ADDRESS: 23 Richardson Ave. PETITION: 020-99 North Andover, MA 01845 HEARING:6/22/99&7/13/99 The Board ofAppeals held aregular meeting onTuesday evening, July 13. 199Supon the spp|ioadonofTerry R. Stonecipher, 23 Richardson Ave., North Andover, requestrig a Variance from the requirements of Secton 7, P7.1 & 7.3 for relief of lot area dimension, front setback, and side setback, to remodel a bathroom and push out a wall directly below bathroom and to add 4'to existing screened porch. Property is located in the R-4 Zoning District. The hearing was advertised in �o Lawrence Tribune on 5125i99&G/1/S9 and all abuftem were notified by regular mail. The following members were present: William J. Sullivan, Raymond Vivenzio, Robert Ford, John Pallone. ` Upon a motion made by John Pal|one and 2"by Robert Ford, the Board voted toGRANT aVariance from the requirements of secdon 7, &7.3 for relief of front setback of 9', and relief of side setback of 4'(relief of lot area is not required)and tnallow expansion o(4' to the existing screened porch, and boGRANT aSpecial Permit toallow alteration tnapna-exiobngnon-conforming lot, in accordancewith the revised Plan ofLand bScott Giles, Regi§tpred Land Surveyor, #13972, dated:6123/99. Voting in favor. William J. Sullivan, Raymond Vivertzio, Robert Ford,Qhn 10.4 Variances and Appeals The Zoning Board of Appeals shall have power upon appeal to grant variances from th,4 X of this Zoning Bylaw where the Board finds that oWng to circumstances relating to soil conditions,shape,or typography of Kela or structure and especially affecting such land or structures but not affecting generally the zoni6g district in general,a Iiteral.�- enforcement of the provisions of this Bylaw will involve substantial hardship,financial or otherwise,to�epedtoner or appik-a a: and that desirable relief may be granted without substantial detriment to the public good and without nullifying or substanti derogating�cm the intent or purpose of this Bylaw. Ut Note: The ganting of the Variance and/or Special Permit as requested by the applicant does not necessaril- the ganting of a Building Permit as the appLicant must abide by all applicable local,state and federal and buA�< codes and regulations,prior to the issuance of a building permit as requested by the Building Commission. By order of the cning Board of Appeals X z lij 0 cc 112 1... A C'77 i . Registry of Deeds 71, j North District of Essex County err Distri . : Lawrence, IA 01840 08/10/99 S. STONECIPHER DJB # 150 0 Cert. Copies 1.50 y - tl Total 1.50 # 151 Payment Cash 1.50 THANK YOU' Thomas J. Burke Register of Deeds NORTH Q Town of L ®ve r No.34z - $ 13 °� 17 0 L 0 dover, Mass A4 CHI RA T E 1) P" Cl 5 BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT........7' .......... .iVti, t Vol!................... .... BUILDING INSPECTOR ....... .. . ..... ...... .... .. .. Foundation has permission to erect... ....... buildings on ......da.3...... ........... Rough ...... ..... . ....l .. z . . ..... ... to be occupied as..!!I!..E j A r Y.,& U*'*oom ra Cift 0 0 7:6himney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. Z M A A PPrOU41 * Ca0"I PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. C &/=Z *.- W1 3/of 9 Rough rn 3 ) PERMIT EXPIRES IN 6 MONTHS Final r) UNLESS CONSTRUON PTAPfELECTRICAL INSPECTOR S Rough 64040 C kv. 13 ***,**I#m........... ............................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. ,� � L!/ ,. ...� i I � � _�_ - �j� I ; .. .�_ . . -. �=��65 -S. 1111 1 a � i i i E 4 I� I �, ,_ - _�'�_iii.J--�...._ -_ � - . � i� ( i 1 i t ._. -_. -� �. _� ___ __ ._ _ __ __'_. _ ! 1 � ) i r :��1 � +i I i - _ I i 5� --�' i i _ � Y) I ' --_ -- ' -_� f .._ __ _._.__. __ - - ___, _ -� - - - i � f i � ��� .�� ! - -, - � _! � ----- i„ i+ i � '^' t -� ... � 1 f Massachusetts The Commonwealth•of �_.. - ( Department of Industrial Accidents — MIC8 0//BOVS119a1190S - 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit location: City nhone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity F-1 lam an employer providing workers' compensation for my employees working on this job. tomoary mate address: _ city phone�- in�urancecu. r-1 I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city phone d insurstnce co policy# C com,jany.name, addre,; I/+° o^ 21` f phone# Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a the up to 51,500.00 and/or one years' imprisonment as well as civil penalties in the form of:t STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury t he information provided above is true and correct Signature _ Date Print name Phone# olTicial use only do not write in this area to be completed by city or town official city or town: permit/license ti -Building Dej C3Licensing Bo 7 check if immediate response is required C3Selectmen's C]Health Depa contact person phone#: -Other (rw d 3191 PIA) h��o _. rtrr�I 5-- ��--- .,. - J�P (90A177200't/!/QlJ��17 P�. ll.QLIILfYz//JPI�i — DEPARTMENT OF PUBLIC SAFETY 1 _ CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Birthdate: CS 012698 0712711999 0712111950 sr Restricted To. 00 BERTIN R ROY 123 NORTH ST ;,� ANDOVER, MA 01810 NORTH Town of ` _ s Over 0% No.,3417 o� �o� L E dover, Mass., S 3 ADRATED F'P�,`�� 1 S IsG _ 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.. ........ +ern� ............... ......&ti.t... r .......... ............................................ ....... Foundation has permission to erect............. g 3 R1 c l% N at j 0 v C��..........�... buildings .....Oz........ .............................................................. ... .V't Rough E�J1Ar 3.ti`�1�root" I4o� o t� to be occupied as � .�. � � � T S cr�'o� NC himney provided that the person accepting this permit shall in everyrespect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. Z 13 A A p O rn t A I '# o a o--°r PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. C O a% *- *?b b/41q Rough IM 3 ) PERMIT EXPIRES IN 6 MONTHS Final 1 r) UNLESS CONSTRU ON PTAPS ELECTRICAL INSPECTOR 133 13 Rough 0001 0 .... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. S 7UfL=-C lNaO \ i f f JZ' i � H Z� K_ CK I i I I I _OO �lG�-- ___� 77 by Y / b S T G r,ci � j I SII 1i ! lit 23I 16 AilI - - - -- 1725 " 7-7 T _ I 1U�30 72 A, 1 .Sour V / i I k ' ( r i 1 s ' � - � � � v ------� I I i �� J I � � < � � - �. r. �, ' � ' i l : � ' . � �� � I � ; ' 4 ' ' ! � 1 i i � � I ` t 4 __ _..___ _�_ _ _ 4�,���� _ ______ _ --� � � ?� I ;� � � � ! � t �� i ! � � i �! � !( I1 j I 1i � { I !i C li ' �' I . I �. ii � ,. , : � � � i < <� . I . << r, i . , I �. �. . E I I ,� I �I I Date. �'.".O R'r:�� TOWN OF NORTH ANDOVER � �r .`.r -�•..'•°oma PERMIT FOR PLUMBING s � s �SSACHUS This certifies that 0 6 . . . . . . . . . . has permission to perform . . .IA .S . . ... . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . .�.t G.��.c c.i.��•ti.z• . . . . . . . . . . . . at . . North Andover, Mass. I . Fee. Lic. No.. ? .`t.?. . . . . . . . . �, PLUMBING INSPEC OR Check # k 3 5340 + n SACHUSETTS UNIFORM APPLICA s; �V TION FOR-PERMIT,TO DO PLUMBING 5 �e ar print). � .. ,�: ---THANDOV4K MASSACHUSETTS Date g ` 'o Z Building Locations Z312+G14!>+�$t7� t1�_ Permit # S y6 i Amount Owner's Name New 0 Renovation U Replacement Plans Submitted Q FIXTURES a rA a d t •i :s W W A C1 &AS1H1VrTIT't. {. • ; 2P11 HAA,.. .. . 3RD FIOM 41H FIlDOt 51H 1� 61H HOR .71H FUM SiFlt FUM (Print or type), , Check one: Certificate J Installing Company Name_U9i Tf,/�'ril— , •�-• y�4 hhij4 ® Corp. Address -_ P, d Qty 72S Partner. NO OjDDto ggf� Business Telephone 9.7 A3 , Ci7(C_, Firm/Co. Name of Licensed Plumber: d( –lS i4d-IUIti Insurance Coveraee: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond ❑ v. Insurance Waiver: J,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby,certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus State Plu bin Code and Ch ter 42 of the General Laws. By: Signature of Eicensea [ er Title Type of Plumbing License City/Town wen u er Master Journeyman ❑ APPROVED(OFFICE USE ONLY